Provider Demographics
NPI:1982378907
Name:TIMOTHY, GABRIELLE (CNA-HHA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:TIMOTHY
Suffix:
Gender:F
Credentials:CNA-HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9245 SHEPTON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3786
Mailing Address - Country:US
Mailing Address - Phone:386-864-1143
Mailing Address - Fax:
Practice Address - Street 1:1002 CLEAR CREEK CIR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-4402
Practice Address - Country:US
Practice Address - Phone:386-569-4137
Practice Address - Fax:352-708-5269
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion